Medicaid Enrollment Reaches New Record

The number of Oklahomans enrolled at one time in the state’s Medicaid program reached an all-time high in March, and officials are examining whether many people who signed up were spurred to do so by the Affordable Care Act.

By the end of March, there were 830,850 Oklahomans enrolled in SoonerCare, the state’s Medicaid program; that was the highest single-month total of enrollees since the program began, according to data from the Oklahoma Health Care Authority.

The number increased by 3.8 percent, or 30,320, during the six months from Oct. 1 to March 31, the same period as the Affordable Care Act’s open enrollment. During the six months from April 1 to Sept. 30, 2013, the number of enrollees increased by 2 percent, or 18,321.

Nearly two-thirds of SoonerCare enrollees are children.

State officials said they expect the growth in new enrollees to cost about $36 million this fiscal year, of which about $11 million would be covered with state money and the rest by federal funds.

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The Health Care Authority expects the total number of enrollees to drop in April, as coverage for certain program participants expires because of a tightening of income requirements. It’s not clear how that will affect the count of total unduplicated people who participated in Medicaid during the fiscal year.

Income requirements for pregnant women seeking “full scope benefits” and women seeking coverage for family planning services were lowered from 185 percent to 133 percent of the federal poverty level on Jan. 1. SoonerCare’s full-scope benefits for pregnant women allow for medical coverage for the pregnancy and other unrelated medical issues.

Pregnant women earning up to 185 percent of the federal poverty level can still qualify for “limited scope” SoonerCare benefits, which cover the pregnancy, but not medical issues unrelated to the pregnancy, said Jo Kilgore, spokeswoman for the Oklahoma Health Care Authority.

The tightened income requirements were put in place because women earning more than 133 percent of the federal poverty level could get similar coverage through the federal online marketplace, Kilgore said.

In 2012, Gov. Mary Fallin decided not to expand Medicaid under Obamacare, which would have added thousands of ineligible people to the SoonerCare rolls. An increase in Medicaid enrollment was still expected in Oklahoma and nationally, however, because experts predicted many people who already qualified for the program but had not signed up would enroll due to the Affordable Care Act’s increased outreach and coverage mandate. This is called the “woodwork” effect, because people would come out the woodwork to sign up for Medicaid.

An example is when an uninsured person who is eligible for Medicaid tries to buy private insurance at healthcare.gov, the federal marketplace website, and instead is directed to enroll in Medicaid.

Kilgore said the agency will try to measure the Affordable Care Act’s effect, partly by determining how many new SoonerCare enrollees were referred to the program by healthcare.gov.

Other factors, such as the economy, also tend to drive increases and decreases in SoonerCare enrollment, Kilgore said.